Friday, February 26, 2010

First of all, kudos to Lynn Woolsey, Barbara Lee and the Progresive and Black Caucuses for presenting just the right statement on the public option; to HuffPo for giving it (and us) space; and to the 1.2 million people who stood up in one day(!) around the country yesterday for comprehensive reform. All this certainly paved the way for final statements by Murray and Pelosi on the public option.

The upshot? Obama's timeline - up to 6 weeks - to resolve all this was worrisome, if he meant to suggest this could drag on through Easter recess.

But on the whole, I think it was a careful and methodical dismemberment of every Republican argument and proposal. After both sides agreed that it was imperative to do something about the health insurance crisis, and almost 5 hours of discussion, Boehner retreated back into the standard Republican tropes and misrepresentations. It left the President sounding like the soul of reason and consideration in stating that he could not settle for a Republican plan that made no progress and would at best cover 3 million of the 45 million uninsured. He outlined places where the Democrats had already compromised (no public option, allowing insurance companies to trade across state lines, within the context of a national exchange), and offered a few weeks for the Republicans to consider if they had actual compromise proposals. But he made a firm commitment to move forward if the two sides could not agree soon. It made the reconciliation process, with a 51 vote majority, seem like a desirable process, and perhaps one the country would do well to rise up and demand.

Saturday, February 20, 2010

The public option, declared dead on a regular basis, is still supported by aboout 60% of the public, and probably a majority of Senators, who are piling on to a ststment of support initiated by Sen. Bennet of Colorado. Ask your senators to join in, or thank them if they did.

For contact numbers and a script, see the PCCC/DFA/Credo public whip count here:
http://whipcongress.com

Read the letter here:

http://whipcongress.com/letter-senate?source=med

The intention is to seek a nationally administered plan as part of the national exchange that will be available to individuals and small employers. It will be more effective if it is open to more enrolleess. Large numbers are the only way any health insurance scheme can work. As recently as December, Senator Rockefeller and others pushed for a PO that everyone could choose, including employees of large firms. This formulation did not prevail. It will have to remain on the agenda for the next round, as will single payer.

Why and how could it work? It's true that large numbers are the centerpiece of effective insurance plans.

It will likely have a higher enrollmenr than the original hastily written and brief CBO projecction, which predicted that the PO would charge higher premiums than the average plan, something that is expressly forbidden in the language of the bill itself.

Is it an attempt to put the risk of expensive cases on the public sector, while leaving the profitable business to the private sector? Death spirals - where healthy people quit and only people with expensive health conditions remain - are a problem now for publicly sponsored high risk pools, and the excuse for Anthem Blue Cross raising its rates by 39%. The difference is that the public option will be one choice for people who are all going to buy insurance anyway. Healthy individuals buying insurance are just as likely to choose the public option as a private one - probably more likely.

Where does something like this work now? While not the definitive case study, in California counties where public plans compete with private plans for enrollees in the State Children's Health Insurance Plans, the public sector does very well in enrollment and cost.

Some single payer supporters have not only retreated from support of the public option, they actively organize opposition, calling it "puny" and a plot that would destroy prospects for single payer in the future.

A great deal has been writtn about the PO, including in hours of Congressional testimony, all online. So just a few comments here:

The public option just isn't an insurance industry plot. Activists are fighting to make it a nationally administered alternative that will be as effective as possible. AHIP's opposition to the public option is a matter of public record, and their payments to the Chamber of Commere to oppose it were reported in the NY Times. If advocacy for the PO is also really an insurance industry plot, surely there would be some evidence somewhere - ?

It's not as good as a single payer, which is not attainable now. It is a placeholder that can be used and improved over time. The alternatives are no bill, or a bill without a public option.

Think about these statements, and then go look up tautology:

The public option could never work; the insurance industry will never let it work; the public option is a plot by the insurance industry to destroy the single payer movement.

You can't trust the government to do anything right; look at how the government mishandled Katrina.

Thursday, February 18, 2010

We keep hearing that people like the health reform peoposal - once they find out what it's about. EQUAL's PowerPoint offers slides you can choose from to describe:

The Problems
- Cost, Access, Quality
- Financing, Organization, Delivery
Health Care and Health
Why Insurance Doesn’t Work
The Politics of Reform
The Proposals: House and Senate
Keep Fighting for Single Payer
Fix It and Pass It!

Download it and use it - talk to your class, neighbors, friends - in the lead up to
President Obama's presentation on Feb. 25. Download it at:

Tuesday, February 2, 2010

Most people in this country would like to get the health insurance industry off their backs, given a choice.

There is an increasingly polarized clamor from the left and the right claiming that the modest but effective incremental proposals coming from Congress are leading us down the path of tyranny and corporate control.

Let’s be clear about who is controlling what.

Corporations exist to generate profits. They want them now and they don’t want a lot of guff about it. People (other than corporate executives) get to have a bit of the wealth if we fight for it. (It helps motivate us to produce and consume the goods and services that generate profits.) If corporations don’t need us any more and can figure out how to do it all with machines, they will. If they can go somewhere else where the population is under tighter political control, they will.

The government isn’t static. It protects corporations and corporate rights. It also protects people and the rights of people and communities. It can strengthen or weaken organizations (like unions) and rules that protect us. It depends on who’s in charge of the government and who is pushing them.

The Democrats’ institutional and financial base includes corporations, as well as organizations and individuals committed to limiting corporate power. Some Democrats are reliable allies. Some are not.

Corporations have an unequivocal political voice. It is the Republican party.

The last 8 years of Republican rule brought us direct cash transfers from our taxes to corporations. That’s why we have a deficit. All that money went somewhere. A lot of it went to the war industry and finance capital. The recent clamor from “independents” about the deficit is not only misdirected, it is perfectly misdirected.

We also got a wholesale incursion on our civil liberties and attacks on our rights, in the name of combating terrorism. The right now complains about a lack of debate after a year of televised hearings – on C-Span!! – while their acolytes invade town hall meetings and derail debate.

If the Republicans regain control of Congress in November, the filibuster rule will go down the drain in the first month. I shudder to think what they’ll do in the second. I’ve never lived in a fascist state, I’ve only read about it, and talked to people who have.

How can we protect our rights and challenge corporate power?

We can support laws that rein in the power of corporations to take our money and do whatever they damn well please.

The health reform bills would do that.

They establish that we Americans have the right to get health care, a principle accepted all over the rest of the world. We’re Americans so we say you have to pay in to claim the right. But the bills take a giant step in the right direction.

Not a small, insignificant step. A giant, major step.

They say that once you pay, you have to get what you paid for. The Mafia elements of the health insurance industry are under attack. Will the new laws be strong and effective enough? They could be. We have to pass them and then we have to fight to make them work. This is possible. We can do it this year. Here’s what else we would get:

1. Health care availability for most of those left out now.
2. A requirement that employers also contribute to the cost of health insurance.
3. Premium credits help make insurance affordable for incomes up to 400% of poverty.
4. A national health insurance exchange, the first step towards a national plan.
5. Coverage for comprehensive benefits
6. Ban on insurance industry abuses like pre-existing condition exclusions, rescissions
7. Payment incentives and other measures to improve the quality of care, including moving away from specialty care to preventive care to address our critical public health needs.
8. Negotiated drug prices through Medicare.

Canada had years of doctors’ strikes after passing universal coverage. But they stuck with it, fought for it, and made it work. (No, just passing the law wasn’t the end of it. They still had to fight. They still do.)

We can pass laws that strengthen the power, funding and authority of the public sector vs. the private sector. The public option would do that.

The better route would, of course, be to get corporations out of health care. Let’s talk about why no one who believes that made a serious effort in 2009 to make it happen:

We don’t have the power to do it. We don’t have the movement. It will take massive, determined grass roots mobilizations to make it happen.

The American public might get there some day. It might or might not be about health care. But we’re generally pretty healthy, and the health care system is complex and amorphous.

People are getting educated about “single payer” proposals. This is great. Some assert that the American public is already in favor of single payer, and is being restrained from achieving it because the Democrats haven’t proposed it. This is an inspiring belief. There have been about 30 people arrested nationwide in support of single payer. Maybe 100. This is a good beginning. Expanding Medicare for some or for all is a popular proposal, and we can continue to fight for it.

Is it a ruse that the corporations oppose health care reform? Not according to them. The Chamber of Commerce and American’s Health Insurance Plans joined forced to kill the pubic option. The NY Times (Jan. 31 p. 21) quotes Chamber chief R. Bruce Josten on the fact that “Despite the Democratic majorities in the House and the Senate, they have not been able to muster support for a single final bill [on health reform]. ‘We had a good year. I have no regrets.’”

Are they just fooling? Were their lobbyists all over the Committees writing the bills, just in case something passed? You bet. When they thought it was inevitable and unstoppable they were there getting their licks in. They are, perhaps, rethinking. Do they want the package to pass? No they do not.

The Democrats need to take another look at who’s voting for them and why. They need to go back and pass a bill that expands union organizing rights, as well as a jobs bill and small business tax credits. They need to go through the reconcilation process to pass a health reform bill, and they need to do it soon. They should also change the Senate rules so that they need 52 votes for cloture (or whatever number they reliably have).

Then progressives can get back to work pushing the reforms further, and mobilizing our communities to fight for our rights and our stuff. We’ll be able to do it because we’ll be living in a country that is dominated by corporations but still respects democratic rights, one that plays out daily the tensions between capital and people.

In my experience political and social change are hard, take consistent, intelligent work, strategic engagement with influential actors including the public, an analysis of where power lies, an understanding of the role and life cycles of organizations, including the ones that govern us and those that might create change. Atheist that I am, I have been impressed with my friends in the faith community. They are not health policy wonks, but they learn what they need to know, they identify their targets, they figure out what it will take to move them, and they do it. They attempt to analyze reality, engage with the reform proposals as they are and to try to influence them.

We need to pass the health reform bill, and keep the email lists and the relationships we’re building in the process. It’s going to be a bumpy few years, and we’re going to need each other.